What to think about before moving on to IVF

One question I get asked a lot is “how do I know when it’s time to try IVF?”

This can be a tough question to answer because it’s a very personal choice and it’s going to be different for every couple.

It’s a decision that has to be made with your doctor, with your spouse, and by listening to your own inner wisdom.

Your doctor will definitely do some tests to check your hormone levels and sperm quality. Sometimes that reveals a clear issue, but often tests come back “normal” and “unexplained infertility” is the official diagnosis.

If that’s the case, I recommend going through this checklist before starting IVF. Because sometimes correcting a small imbalance in our bodies can make a huge difference in our fertility. Here’s my list of things to consider:

1. You’ve been off hormonal birth control for at least 6 months (I usually recommend a year), and are having regular periods that occur between 26-33 days.

It can take several months for your cycles to re-regulate after being on hormonal birth control. While some women may get pregnant right away, many women will experience several months of irregular periods as their bodies and hormones get back into the swing of things. For some women this can take up to a year. While there may be some other issues at play (especially if your period wasn’t regular before you went on the pill), there isn’t necessarily something wrong if you don’t get pregnant right away. Your ovaries and brain are re-negotiating their relationship, and for many women this will get sorted out naturally with a little patience–although there are some things you can do to support your hormones (See #6 + #7)

2. You’ve been tracking your cycle using a sympto-thermal method for at least 6 months (and KNOW you are in fact ovulating), and you’re timing intercourse for your most fertile days

Knowing your cycle and being able to determine your most fertile days is key to getting pregnant. I know that seems obvious, but a lot of women do skip this step. If you’re not tracking your cycle daily, it could be as simple as getting your timing right. Taking your body temperature daily and tracking your cervical fluid and position will tell you without a doubt whether or not you even ovulated this month (if you’re not, then you have a tangible problem to fix), and it will help you predict your most fertile days with more confidence (no more trying to read those ovulation predictor strips). Want to learn how to track your cycle? Grab my free mini-series here.

3. You’ve had a full thyroid panel done (not just TSH), and been tested for Epstein Barr Virus.

Hypothyroidism (and it’s autoimmune cousin Hashimoto’s) and Epstein Barr Virus are two stealthy problems that can have a big impact on your hormones. If you’ve been experiencing fatigue, weight gain that won’t budge, extra sensitivity to the cold, or brain fog, get your thyroid tested. Make sure you have a FULL thyroid panel done (including reverse T3 and thyroid antibodies), not just TSH. If your doctor only orders a lab for TSH, ask her to run a full panel as this will give you a more complete picture of how your thyroid is functioning.

Epstein Barr Virus is something we all have in our bodies (it’s the same virus that causes mono), and we’ve all likely been exposed to it before, but it can occasionally become reactivated during times of stress, meaning our immune system is secretly working hard to manage this stealth infection. If you’ve been experiencing fatigue, achiness, an inability to handle stress, or have new onset autoimmune issues, I’d recommend getting tested for EBV as well. It can be checked with a simple blood test.

4. Your liver and gut are both healthy.

Both your liver and your gut are super key to keeping your hormone levels healthy. A sluggish liver and poor digestion can often result in hormone imbalance. If you have symptoms like gas, bloating, skin problems like acne or eczema, new food sensitivities, constipation or loose stools, fatigue, or seasonal allergies, and sensitivity to coffee or alcohol, your gut or liver might be the culprit. These imbalances can easily be addressed with food and supplements, and you’ll feel way better, too!

5. You’ve taken time to manage your stress and cortisol levels.

We are always going these days, and chronic low-grade stress can really start to wreak havoc on our hormones. When your cortisol (one of your stress hormones) is too high for too long, it starts to throw everything else in your body off. If you have symptoms like fatigue, new anxiety or depression, irritability, brain fog, a few extra pounds around your middle, trouble getting going in the morning, or being wired yet tired at night, your cortisol might be an issue. Doing simple mindfulness practices throughout the day like deep breathing, meditation, or gentle yoga can do a lot to support your body’s stress response.

6. You’ve detoxed your personal care items like makeup, shampoo, deodorant, soaps, detergents, and household cleaners and are using non-toxic and eco-friendly products.

All the toxins in our household cleaners, deodorant, makeup, and other products seep into our bodies through our largest organ: our skin. This can overload your liver and start to mess with your hormones and egg health. Switching to non-toxic and eco-friendly products can go a long way toward supporting your fertility. (You can learn more about this and my top clean beauty substitutions in this post)

7. You’ve cleaned up your diet (removing added sugars and processed foods and adding more whole foods and veggies) and are taking a high-quality prenatal supplement.

A healthful diet and proper nutrient intake are so important for hormone balance and creating an inviting environment for a baby. This is one of the simplest things you can do to support your fertility, but often one of the hardest things to change! Think whole foods, more green veggies (especially cruciferous veggies like broccoli and kale), and limit sugar and processed foods. Make sure every meal has some high-quality protein and good fats (like nuts, seeds, avocados, or pasture-raised meats) to help keep your blood sugar level.

If you’ve done all these things and still aren’t getting pregnant, it may be time to talk to your doctor about trying IVF.

But if you haven’t done all the things on this list (ESPECIALLY #1-3), definitely try these first. Getting pregnant isn’t always as easy as it should be, but sometimes correcting a small imbalance or understanding our bodies a little better can make all the difference.

None of these things are a quick fix and do require some commitment in order to fully support your body and your health. I know many of you also feel time pressure, which can also factor into your decision to try IVF sooner rather than later. And that’s totally fine. Even if you have decided to go ahead with a round of IVF, make sure you’re also doing all the things on the list above, as they will give you the best shot at a successful IVF experience.

If you’d like support figuring any of these things out, I’ve opened up 10 spots for Fertility Focus Sessions on my schedule for the next month. Book your session here>>

In this 90-minute session, we’ll chat about your fertility history, what factors might be affecting your fertility and we’ll map out a plan of action to help you support your body, whether that’s determining any testing you need to get done, or mapping out a plan to change your diet.

I hope this list gives you a better idea of how to approach your IVF decision, but remember to trust yourself and your own internal wisdom as well. Ultimately, IVF may be the right decision for many women, but it’s a difficult journey on it’s own and I always want women to have the best shot at success.

Now I’d love to hear from you! Which of these things surprised you? I’d love to hear your questions, comments or experiences in the comments below!